胸腔镜下手术与开胸手术治疗肺隔离症的临床比较分析

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1、Studyofcomparingtheclinicaleffectofconventionalthoracotomyandvideo—assistedthoracoscopicsurgeryintreatmentforpulmonarysequestrationMasterdegreecandidateLiWeipengSupervisorProfessorLiJiliangVice—supervisorProfessorSunBingMajorCardio—ThoracicsurgeryAbstrac

2、tObjectiveTocomparetheclinicaleffectofconventionalthomcotomyandvideo—assistedthomcoscopicsurgery(VATS)intreatmentforpulmonarysequestration,discussingtheclinicalvalueofvideo-assistedthoracoscopicsurgery．MethodsRetrospectiveanalysedthe33casesofpulmonaryseq

3、uestrationintheFirstHospitalofDalianMedicalUniversityfromJanuary2000toDecember2010．33casesweredividedintotwogroups，including11casesweretreated诵tllVATS，and22casesweretreated诵tllconventionalthoracotomy．Comparedtheoperativetime，incisionlength，bloodloss，thet

4、imeofchestdrainageandthepostoperativehospitalstay．Results22casesweretreated诵tllconventionalthoracotomy．11casesweretreated、析mVATS．Therearestatisticallydifferenceinexperimentalgroupaboutthepostoperativehospitalstaytime(4．27+0．27)day，incisionlength(5．36+0．1

5、6)cmandthetimeofchestdrainage(3．09士0．21)daycomparedwithconventionalthoracotomy(controlgroup)口<0．05)．Nostatisticallydifferenceexistedintheoperativetimebetweentheexperimentalgroup(115．91士11．576)minandthecontrolgroup(137．50士7．81)min(P>0．05)．ConclusionVideo-

6、assistedthoracoscopicsurgery(VATS)inthetreatmentofpulmonarysequestrationisbetterthanconventionalthomcotomyinincisionlength，bloodloss，timeofchestdrainageandpostoperativehospitalstay．Thereissignificantlyclinicalvalue．KeyWordsVideo—assistedThoracoscopicPulm

7、onarySequestration2．▲‘-—J-刖舌胸腔镜手术(video．assistedthoracoscopicsurgery，VATS)又称为电视胸腔镜手术，是近年来逐步广泛开展起来的一项胸外科手术技术，它与传统开胸手术相比较具有创伤小、疼痛轻、术后恢复快、手术切口疤痕小等诸多优势。随着腔镜技术的发展、腔内手术器械的不断改进，胸腔镜手术技术不断成熟，应用范围越发广泛，胸腔镜手术在胸外科手术中所占比例逐年上升。美国胸外科医师协会已于2006年把胸腔镜下肺叶切除术列为胸外科肺叶切除术的标准术式Ⅲ

8、。近年来国内此项手术开展也越发广泛，成熟应用胸腔镜手术技术完成肺叶切除术代表胸外科医疗水平的进步。肺隔离症(pulmonarysequestration，PS)是一种少见的先天性发育异常的肺部疾病，主要由于胚胎发育异常导致，动脉血供来源于体循环。以是否有完整胸膜包裹区分为叶内型肺隔离症和叶外型肺隔离症。临床缺乏特征性表现，诊断困难，主要以咳嗽、咳痰为主要表现。随着影像学诊断技术的发展，临床确诊病例增加。肺隔离症原则上确诊即应手术治疗，传统手